Provider Demographics
NPI:1487666152
Name:DC MEDICAL SUPPLY, INC
Entity Type:Organization
Organization Name:DC MEDICAL SUPPLY, INC
Other - Org Name:MORE MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-722-4721
Mailing Address - Street 1:5922 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5120
Mailing Address - Country:US
Mailing Address - Phone:202-722-4721
Mailing Address - Fax:202-563-4366
Practice Address - Street 1:5922 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5120
Practice Address - Country:US
Practice Address - Phone:202-722-4721
Practice Address - Fax:202-563-4366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC20269OtherDC ALLIANCE PROVIDER
VA1487666152Medicaid
DC4475OtherHEALTH RIGHT PROVIDER
MD400618600Medicaid
MD185852OtherAMERIGROUP PROVIDER
DC034275400Medicaid
VA1487666152Medicaid